The pieces are in place for an improved medical examiner's office in Oklahoma — now supporters say it's time for the Legislature to act.
Two years after a new chief was hired and a year after the agency gained $2.5 million in supplemental appropriations, forensic investigators and pathologists say they are still overworked and behind on finalizing cases.
But with the roster of doctors expected to double over the next few months, all that's really needed for the agency to regain accreditation is a new facility, said Dr. Eric Pfeifer, chief medical examiner.
“By October of this year they'll all be in place so I think you'll really start seeing some change in workload distribution and turnaround time decrease,” he said. “Until then we're still limping along with three pathologists.”
It's no secret that the state office charged with investigating suspicious deaths has been embroiled in turmoil since at least 2007.
A revolving door of chief examiners, the loss of national accreditation in 2009, repeated allegations of sexual harassment and a monumental backlog of unresolved investigations made it easy for lawmakers to reject repeatedly the agency's bid for a new facility. But now lawmakers, agency heads and even office employees say a culture change under Pfeifer's leadership — plus a little financial boost — have made a world of difference.
“We could not have asked for a better medical examiner,” said Charles Curtis, deputy director of the Oklahoma State Bureau of Investigation, which often relies on medical examiner reports in determining whether a crime was committed. “He had a plan when he came in, he developed one, and he's pretty well stuck with that plan.”
“He's not a hack that came in with an agenda — he's a responsible doctor who's trying to come in and practice medicine in pathology,” said Sen. Clark Jolley, R-Edmond. “He's focused, and I think he's intent on trying to do his job.”
Dr. Chai Choi, a pathologist at the agency's Oklahoma City office since 1983, said Pfeifer is the best chief she has had.
“We are very fortunate,” she said. “He is young, he is outgoing and very passionate about it.”
Attacking the backlog
The first thing Pfeifer did when he took over as administrator was change its employee culture. Though it meant the firing of three Tulsa employees — including one prominent pathologist who had previously worked as its acting chief — employees said today say they are happier and feel more support than ever.
The second thing he did was attack the backlog of unresolved cases.
When Pfeifer started in May 2011, there were 320 cases of autopsy reports that had been pending for more than two months. By January of the following year, that backlog had been wiped out to zero.
That was a strenuous task, he said, and he may have asked too much of his employees. Now, that backlog has grown to over 600, including 31 that have been pending for more than a year.
“Their family lives suffered, their personal lives suffered, and that was not the way to go,” he said. “I had docs say to me, ‘I can't take the pace, I'm going to leave,' or, ‘My wife is about to divorce me because I'm spending too much time here,' and so I said, ‘OK, this was too ambitious for what we could do.'”
In 2008, seven pathologists averaged almost 2,600 cases apiece. Last year, five averaged almost 4,400.
Despite two less pathologists on staff, the agency saw its caseload increase from about 18,000 annually to 22,000 over that time period.
But the extra push improved the number of cases finalized within 90 days from 70 to 78 percent, according to agency data.
And help is on the way.
The new appropriations approved last year boosted the agency's annual budget to $7.2 million. A million dollars was spent on equipment upgrades — new computer systems, a digital X-ray machine, and an “evidence hanging machine” that replaced hangers in a broom closet.
The rest was spent hiring five new doctors, Pfeifer said.
“The problem with that is it takes about a year, sometimes a year and a half, to move their families from out of state or wherever they're coming from, so although we've hired more only one of those is in place,” he said.
Still, these improvements pale compared to what it will take to bring the office into full compliance, he said.
The agency needs a budget of about $13-14 million for that, he said, and perhaps more importantly it needs a new facility.
Space is so limited in the morgue at the Oklahoma City office that examiners have developed a special protocol just for moving around the autopsy tables. Ceiling panels have rotted out where the roof leaks water.
The autopsy tables themselves — three, where Pfeifer says there should be at least six — are so outdated their fumigation systems hardly work and the drains underneath spill over with fluids.
Last year, the office's coolers shut down during the peak of summer heat, forcing examiners to move its bodies into refrigerated trucks.
A plan to issue bonds for a new building on the University of Central Oklahoma campus in Edmond — estimated at $42 million, including equipment — was blocked by lawmakers in the House of Representatives last year.
A revised plan, which would have included the building in a master lease program, bonded as a package with several other university projects, was also met with skepticism.
Moving to new offices
A bill passed by the Senate earlier this month reinstated the proposed facility back into the state's proposed bonding plans, but House leaders have again expressed reluctance to borrow the money.
A spokesman for House Speaker T.W. Shannon said the working plan is to include a new medical examiner facility in its eight-year infrastructure plan.
Pfeifer said whatever the plan, he needs the money sooner rather than later.
“Either way you have to appropriate the money through a bonding issue of some sort or pay cash for it, and I think that's ultimately a House issue,” he said. “We've been talking to Speaker Shannon and other House members and I think everyone agrees we need a new structure, but again I guess we'll just leave that up to the end of the session and see if that happens.”
He said once the office moves into a new facility it could take six months to a year to regain accreditation.